National Provider Identifier

Diane O Bullock, LPN

Diane O Bullock, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 490-3369.

NPI 1417286535Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1417286535
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
December 19, 2009
Last Updated
December 19, 2009

Practice Location

  • 2660 Chili Ave
  • Bldg 28 Apt 14
  • Rochester, NY 14624-4101

Phone: (585) 490-3369

Mailing Address

  • PO Box 17523
  • Rochester, NY 14617-0523

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1417286535
Entity Type
Individual
Last Name
Bullock
First Name
Diane
Middle Name
O
Credential
LPN
Mailing Street Address
PO Box 17523
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-0523
Mailing Country
US
Mailing Phone
(585) 490-3369
Practice Street Address
2660 Chili Ave
Practice Address Line 2
Bldg 28 Apt 14
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14624-4101
Practice Country
US
Practice Phone
(585) 490-3369
Enumeration Date
December 19, 2009
Last Updated
December 19, 2009
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)